RESUMEN
O presente estudo tem por objetivo realizar um relato de experiência demonstrando a percepção de discentes do curso de odontologia na sua participação na prática da atenção primária à saúde (APS), vivenciadas em um cenário pandêmico e com base no combate a enfrentamentos e desafios impostos no processo de trabalho das equipes de saúde da família. Este estudo trata - se de relato de experiência, de caráter descritivo e retrospectivo, associado à uma pesquisa bibliográfica para que trousse o embasamento teórico necessário para a descrição do relato de experiência vivenciado. No decorrer da pandemia, a Equipe de saúde da família exerceu importante papel e atuou na linha de prevenção e controle desta, sendo uma das maiores ferramentas de apoio. Na odontologia, a atuação da equipe de saúde bucal devido a fatores de risco inerentes à esta modalidade de ocupação, ficou limitada em seu exercício. O conhecimento de muitos dos profissionais da rede pública foi colocado em questão, assim como sua vivência, limitações e o medo de contrair a doença. Os profissionais da equipe de saúde, mostraram que o trabalho interprofissional e um bom relacionamento aumentou o incentivo e a responsabilidade de equipe.
This study aims to carry out an experience report demonstrating the perception of students of the dentistry course in their participation in the practice of primary health care (PHC), experienced in a pandemic scenario and based on the fight against confrontations and challenges imposed on the work process of family health teams. This study is an experience report, descriptive and retrospective, associated with bibliographical research to bring the necessary theoretical basis for the description of the lived experience report. During the pandemic, the Family Health Team played an important role and acted in the line of prevention and control of this, being one of the greatest support tools. In dentistry, the performance of the oral health team, due to risk factors inherent to this type of occupation, was limited in its exercise. The knowledge of many public health professionals was questioned, as well as their experience, limitations and fear of contracting the disease. Health team professionals showed that interprofessional work and a good relationship increased team incentive and responsibility.
Asunto(s)
Humanos , Atención Primaria de Salud , Estudiantes de Odontología , Pandemias , COVID-19 , Condiciones de TrabajoRESUMEN
Introdução: O conhecimento da magnitude em que a população implementa medidas de proteção emitidas pelas autoridades de saúde pública é essencial na prevenção da doença do novo coronavírus (COVID-19). A eficácia de medidas não farmacológicas de prevenção e das políticas públicas destinadas a reduzir o contágio pela COVID-19 depende de quão bem os indivíduos são informados sobre as consequências da infecção e as medidas que devem adotar para reduzir sua propagação. O entendimento, as atitudes e as práticas das pessoas em relação à COVID-19 e sua prevenção são basilares para a compreensão da dinâmica epidemiológica, demandando a realização de pesquisas sobre o cumprimento de medidas não farmacológicas de prevenção do contágio em diversos territórios. Para isso, em 2020, medidas não farmacológicas contra a COVID-19 foram divulgadas por fontes diversas, estatais e privadas, para a maior parte da população brasileira, com a finalidade de orientar comportamentos para conter a crise sanitária. As equipes da Estratégia Saúde da Família têm um papel fundamental neste processo de educação em saúde, pois compreendem elementos socioculturais das suas comunidades, alcançando-as tanto em capilaridade quanto em adequação local da informação técnico-científica. Este artigo abrange uma pesquisa de campo, parte de um projeto multicêntrico nacional. Objetivo: Avaliar se a população do território de uma unidade da Estratégia Saúde da Família da cidade de Condado-PE entende e aplica as informações que recebeu sobre medidas não farmacológicas de prevenção em suas práticas de proteção contra a COVID-19. Mais especificamente, a pesquisa visou determinar que informações foram recebidas pelos respondentes, quais as suas fontes, o grau de confiabilidade atribuído a estas, além da adesão deles às medidas não farmacológicas e sua relação com variáveis sociodemográficas. Métodos: O modelo do estudo foi observacional e descritivo, com abordagem quantitativa, a partir da coleta de dados primários com 70 usuários por entrevista presencial com questionário estruturado. Resultados: Os resultados mostraram que a população recebeu vasta informação sobre prevenção da doença. Conclusão: Com níveis variados de confiabilidade das fontes, atribuindo importância relevante às medidas de prevenção e adotou a maioria delas, com exceção do isolamento social total.
Introduction: Knowledge of the magnitude to which the population implements protective measures issued by public health authorities is essential in preventing coronavirus disease 2019 (COVID-19). The effectiveness of non-pharmacological prevention measures (NPM) and public policies aimed at reducing the spread of COVID-19 depends on how well individuals are informed about the consequences of the infection and the measures they must adopt to reduce its spread. The understanding, attitudes, and practices of people in relation to COVID-19 and its prevention are fundamental for understanding the epidemiological dynamics, demanding research on compliance with NPM to prevent contagion in different territories. To this end, in 2020, NPM against COVID-19 were released by various sources, state and private, for most of the Brazilian population, with the aim of guiding behaviors to contain the health crisis. The Family Health Strategy (FHS) teams play a key role in this health education process, as they comprise sociocultural elements of their communities, reaching them both in capillarity and in local adequacy of technical-scientific information. This article covers field research, part of a national multicenter project. Objective: To evaluate whether the population of the territory of an FHS unit in the city of Condado, Pernambuco, understands and applies the information it received about NPM prevention in their practices to protect against COVID-19. More specifically, the research aimed to determine what information was received by the respondents, what are their sources, the degree of reliability attributed to these, in addition to their adherence to the NPM and their relationship with sociodemographic variables. Methods: The study model was observational and descriptive, with a quantitative approach, based on the collection of primary data with 70 users through face-to-face interviews with a structured questionnaire. Results: The results showed that the population received extensive information on disease prevention. Conclusion: With varying levels of reliability of the sources, attributing relevant importance to prevention measures and adopted most of them, with the exception of total social isolation.
El conocimiento de la magnitud con la que la población implementa las medidas de protección emitidas por las autoridades de salud pública es fundamental en la prevención de la enfermedad por coronavirus 2019 (COVID-19). La efectividad de las medidas de prevención no farmacológicas (MFN) y de las políticas públicas dirigidas a reducir la propagación de la COVID-19 depende de qué tan bien se informe a las personas sobre las consecuencias de la infección y las medidas que deben adoptar para reducir su propagación. La comprensión, actitudes y prácticas de las personas con relación al COVID-19 y su prevención son fundamentales para comprender la dinámica epidemiológica, exigiendo investigaciones sobre el cumplimiento de las MNF para prevenir el contagio en diferentes territorios. Con ese fin, en 2020, MNF contra el COVID-19 fueron divulgados por diversas fuentes, estatales y privadas, para la mayoría de la población brasileña, con el objetivo de orientar comportamientos para contener la crisis sanitaria. Los equipos de la Estrategia de Salud de la Familia (ESF) juegan un papel fundamental en este proceso de educación en salud, ya que integran elementos socioculturales de sus comunidades, alcanzándolas tanto en la capilaridad como en la adecuación local de la información técnico-científica. Este artículo aborda una investigación de campo, parte de un proyecto multicéntrico nacional, con el objetivo de evaluar si la población del territorio de una unidad de la ESF en la ciudad de Condado-PE comprende y aplica la información recibida sobre la prevención de MNF en sus prácticas de protección contra el COVID -19. Más específicamente, la investigación tuvo como objetivo determinar qué información recibieron los encuestados, cuáles son sus fuentes, el grado de confiabilidad atribuido a estas, además de su adherencia al MNF y su relación con variables sociodemográficas. El modelo de estudio fue observacional y descriptivo, con enfoque cuantitativo, basado en la recolección de datos primarios con 70 usuarios a través de entrevistas cara a cara con un cuestionario estructurado. Los resultados mostraron que la población recibió amplia información sobre prevención de la enfermedad, con diversos niveles de confiabilidad de las fuentes, atribuyendo importancia relevante a las medidas de prevención y adoptando la mayoría de ellas, con excepción del aislamiento social total.
Asunto(s)
Humanos , Estrategias de Salud Nacionales , Educación en Salud , Comunicación en Salud , COVID-19 , Prevención PrimariaRESUMEN
Introdução: O avanço da pandemia de COVID-19 acarretou alterações no sono da população. Os distúrbios do sono têm relação com as principais alterações de saúde mental e também possuem relação com os fatores psicossociais. Objetivo: Estimar a prevalência e fatores associados às alterações na qualidade do sono em usuários acompanhados na Atenção Primária à Saúde durante a pandemia de COVID-19. Métodos: Estudo do tipo transversal, com adultos (idade >18 anos) de ambos os gêneros, acompanhados por uma unidade de saúde. Foram levantadas as informações do prontuário eletrônico da unidade e, durante a visita domiciliar (entre agosto e setembro de 2021), os dados socioeconômicos, fatores de risco, sinais vitais, variáveis antropométricas, hábitos de vida, medicações em uso, uso dos serviços de saúde, internação e consultas no último ano. A qualidade de vida foi avaliada pelo questionário SF-36 e foi usado o Índice de Qualidade do sono Pittsburgh (PSQI). Resultados: A amostra foi formada predominantemente por mulheres (82,9%) com 60,5±11,7 anos de idade, da cor branca (70,7%), com companheiro (61%) e pertencentes à classe C (65,8%). 53,7% da amostra apresentou até duas comorbidades, 87,8% apresentavam sobrepeso/obesidade e 80% faziam uso de anti-hipertensivo. A prevalência de qualidade do sono ruim foi de 87,8% (IC95% 73,195,0). Os achados apontam para uma relação entre má qualidade do sono com consumo de álcool, presença de ≥3 comorbidades, níveis de PAS, uso de ansiolíticos, nível de escolaridade e uso de serviços de saúde durante a pandemia. Conclusões: A alta prevalência de qualidade do sono ruim na amostra estudada sugere que determinantes sociodemográficos, presença de comorbidades e hábitos de vida devem ser considerados para minimizar os efeitos das alterações do sono na pandemia.
Introduction: The advancement of the COVID-19 pandemic has resulted in changes in the sleep patterns of the population. Sleep disorders are related to major mental health changes and are also associated with psychosocial factors. Objective: To estimate the prevalence and factors associated with sleep quality changes among users attended in Primary Health Care during the COVID-19 pandemic. Methods: This was a cross-sectional study involving adults (age >18 years) of both genders who were being followed at a healthcare unit. Information was gathered from the unit's electronic medical records, and during home visits (between August and September 2021), socioeconomic data, risk factors, vital signs, anthropometric variables, lifestyle habits, current medications, healthcare service utilization, hospitalization, and consultations in the past year were collected. Quality of life was assessed using the SF-36 questionnaire, and the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Results: The sample consisted predominantly of women (82.9%) with an average age of 60.5±11.7 years, of white ethnicity (70.7%), with a partner (61%), and belonging to class C (65.8%). 53.7% of the sample had up to two comorbidities, 87.8% were overweight/obese, and 80% were using antihypertensive medication. The prevalence of poor sleep quality was 87.8% (95%CI 73.195.0). The findings indicate a relationship between poor sleep quality and alcohol consumption, the presence of ≥3 comorbidities, systolic blood pressure levels, use of anxiolytics, education level, and the use of healthcare services during the pandemic. Conclusions: The high prevalence of poor sleep quality in the study sample suggests that sociodemographic determinants, presence of comorbidities, and lifestyle habits should be considered to minimize the effects of sleep disturbances during the pandemic.
Introducción: El avance de la pandemia de COVID-19 ha ocasionado cambios en el sueño de la población. Los trastornos del sueño están relacionados con los principales cambios en la salud mental y también se asocian con factores psicosociales. Objetivo: Estimar la prevalencia y los factores asociados con alteraciones en la calidad del sueño en usuarios atendidos en la Atención Primaria de Salud durante la pandemia de COVID-19. Métodos: Estudio transversal con adultos (edad >18 años) de ambos géneros que son atendidos en una unidad de salud. Se recopilaron datos del historial clínico electrónico de la unidad y durante la visita domiciliaria (entre agosto y septiembre de 2021) se obtuvieron datos socioeconómicos, factores de riesgo, signos vitales, variables antropométricas, hábitos de vida, medicamentos utilizados, uso de servicios de salud, hospitalización y consultas en el último año. La calidad de vida se evaluó mediante el cuestionario SF-36 y se utilizó el Índice de Calidad del Sueño de Pittsburgh (PSQI). Resultados: La muestra estuvo compuesta predominantemente por mujeres (82,9%) con una edad de 60,5±11,7 años, de raza blanca (70,7%), con pareja (61%) y pertenecientes a la clase C (65,8%). El 53,7% de la muestra presentó hasta dos comorbilidades, el 87,8% tenían sobrepeso/obesidad y el 80% utilizaba medicación antihipertensiva. La prevalencia de mala calidad del sueño fue del 87,8% (IC95% 73,195,0). Los hallazgos señalan una relación entre la mala calidad del sueño y el consumo de alcohol, la presencia de ≥3 comorbilidades, los niveles de presión arterial sistólica (PAS), el uso de ansiolíticos, el nivel de escolaridad y el uso de servicios de salud durante la pandemia. Conclusiones: La alta prevalencia de mala calidad del sueño en la muestra estudiada sugiere que se deben considerar los determinantes sociodemográficos, la presencia de comorbilidades y los hábitos de vida para minimizar los efectos de los trastornos del sueño en la pandemia.
Asunto(s)
Humanos , Atención Primaria de Salud , Trastornos del Sueño-Vigilia , Factores de Riesgo , COVID-19RESUMEN
Introducción. En la adolescencia, se comienzan a tomar decisiones autónomas sobre la salud. En la vacunación intervienen dimensiones contextuales, grupales y relativas a cada vacuna. Se busca conocer el proceso de información, confianza y decisión de vacunarse contra COVID-19 en adolescentes usuarios de un centro de salud en Buenos Aires. Objetivos. Identificar ámbitos y canales a través de los cuales los adolescentes accedieron a información sobre la vacuna contra COVID-19 en un centro de salud de Buenos Aires. Describir sus opiniones respecto a los distintos discursos sobre vacunación. Describir su participación en la vacunación contra COVID-19. Identificar barreras y facilitadores respecto del acceso a la vacunación contra COVID-19 en esta población. Población y métodos. Investigación cualitativa. Se hicieron entrevistas semiestructuradas a adolescentes usuarios del efector. La muestra fue heterogénea; su tamaño se definió por saturación teórica. Se realizó un análisis temático de los datos. Resultados. Se realizaron 14 entrevistas. Los entrevistados recibieron información sobre la vacuna contra COVID-19 de sus familias, la televisión y las redes sociales. Todos recibieron tanto publicidad oficial como discursos reticentes a la vacunación. Analizaron la información recibida y formaron opinión autónoma. Su decisión sobre vacunarse no siempre fue respetada. La desconfianza, la baja percepción del riesgo, el temor a las inyecciones, las barreras administrativas y geográficas fueron motivos de no vacunación. Conclusiones. Se requieren estrategias de comunicación destinadas a adolescentes que promuevan su participación en el acceso a la vacunación.
Introduction. During adolescence, individuals start to make autonomous decisions about their health. Vaccination involves contextual, group, and vaccine-specific dimensions. We sought to know the information, trust, and decision to receive the COVID-19 vaccine among adolescents who attended a healthcare center in Buenos Aires. Objectives. To identify settings and channels through which adolescents accessed information about the COVID-19 vaccine at a healthcare center in Buenos Aires. To describe their opinions about the different statements on vaccination. To describe their participation in COVID-19 vaccination. To identify barriers and facilitators to COVID-19 vaccination in this population. Population and methods. Qualitative study. Semi-structured interviews with adolescents who attended this healthcare facility. The sample was heterogeneous; the sample size was estimated by theoretical saturation. A thematic analysis of data was done. Results. A total of 14 interviews were conducted. Interviewees obtained information about the COVID-19 vaccine from their families, TV, and social media. All received information from both official campaigns and anti-vaccine communications. They analyzed the information they received and formed their own opinion. Their decision about the vaccine was not always respected. Hesitancy, a low perception of risk, fear of needles, administrative and geographic barriers were reasons for not receiving the vaccine. Conclusions. Communication strategies targeted at adolescents are required that encourage their involvement in access to vaccination.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Confianza , Investigación Cualitativa , Vacunas contra la COVID-19/administración & dosificación , Argentina , Aceptación de la Atención de Salud/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Entrevistas como Asunto , Vacunación/psicología , Vacunación/estadística & datos numéricos , Toma de Decisiones , COVID-19/prevención & control , Vacilación a la Vacunación/psicología , Vacilación a la Vacunación/estadística & datos numéricos , Instituciones de Salud , Accesibilidad a los Servicios de SaludRESUMEN
This paper explores patterns of communication during the COVID-19 pandemic in four countries with right-wing populist governments during that period, Brazil, Poland, Serbia and the United States, based on interviews with key actors involved in that process. We look at a number of characteristics normally associated with populist rule and political culture likely to affect pandemic communication, including polarization, cultural populism hostile to expertise, personalized rule and machismo, the performance of crisis, and illiberalism. We find that many of these characteristics can be seen in patterns of pandemic communication across the four countries, but also find significant differences in the response of populist leaders between the U.S. and Brazil, on one hand, and Poland and Serbia on the other. Differences can be linked to different varieties of populism in the four countries and specifically their commitment to libertarian or more statist approaches, which also inform disparate public health policies, as well as to different levels of entrenchment of populists in positions of power. We conclude by discussing the politicization of public health and the lessons of the COVID pandemic for emergency risk communication in the era of populism.
Asunto(s)
COVID-19 , Comunicación , Pandemias , Política , COVID-19/epidemiología , Humanos , Brasil/epidemiología , Estados Unidos/epidemiología , Polonia , SerbiaRESUMEN
BACKGROUND: The EAT-Lancet diet is a diet aimed at promoting population and planetary health from the perspective of sustainable diets in terms of environmental and health aspects. This study aimed to assess the association between adherence to the EAT-Lancet diet and cardiometabolic risk factors among adults and elderly individuals in a capital city in the northeastern region of Brazil. METHODS: This is an analytical cross-sectional observational study from a population-based sample conducted between 2019 and 2020, involving 398 non-institutionalized adults and elderly people, of both sexes from "Brazilian Usual Consumption Assessment" study (Brazuca-Natal). There was a 38% response rate due to the suspension of data collection due to the covid-19 pandemic, but According to the comparative analysis of socioeconomic and demographic variables between the surveyed and non-surveyed sectors, losses were found to be random (p = 0.135, Little's MCAR test). Socioeconomic and lifestyle data, anthropometric measurements, and dietary consumption were collected. We used the Planetary Health Diet Index (PHDI) and the Cardiovascular Health Diet Index (CHDI) for cardiovascular health to assess adherence to the diet's sustainability. The evaluated cardiometabolic parameters included fasting blood glucose, triglycerides, total cholesterol, HDL-C, LDL-C, and systolic and diastolic blood pressure measurements. We also assessed the presence of type 2 diabetes mellitus, arterial hypertension, and dyslipidemia. For the data analyses, sample weights and the effect of the study design were taken into account. Pearson's chi-square test was used to evaluate the statistical significance of frequencies. Multiple linear regression models assessed the associations between PHDI and CHDI and its components and the cardiometabolic parameters. RESULTS: The mean PHDI was 29.4 (95% CI 28.04:30.81), on a total score ranging from 0 to 150 points and the mean CHDI was 32.63 (95% CI 31.50:33.78), on a total score ranging from 0 to 110 points. PHDI showed a significant positive association with the final CHDI score and components of fruits, vegetables, and legumes, and a negative association with Ultra-processed Food (UPF) (p < 0.05). Notably, among the most consumed UPF, the following stand out: "packaged snacks, shoestring potatoes, and crackers" (16.94%), followed by margarine (14.14%). The PHDI exhibited a significant association with diabetes and dyslipidemia, as well as with systolic blood pressure, total cholesterol, and LDL-C. CONCLUSIONS: The results suggest that adopting the EAT-Lancet diet is associated with the improvement of key cardiovascular health indicators.
Asunto(s)
Enfermedades Cardiovasculares , Humanos , Masculino , Brasil/epidemiología , Femenino , Estudios Transversales , Persona de Mediana Edad , Anciano , Adulto , Enfermedades Cardiovasculares/epidemiología , Dieta Saludable/estadística & datos numéricos , Dieta Saludable/métodos , Factores de Riesgo Cardiometabólico , COVID-19/epidemiología , Dieta/métodos , Dieta/estadística & datos numéricos , Glucemia/metabolismoRESUMEN
Distrust in science has been linked to scepticism over vaccines and climate change. Using data from nationally representative surveys administered in eight key countries for global efforts to mitigate climate change and COVID-19 (Australia, Brazil, China, India, Japan, South Africa, the UK and US), we find that distrust in scientists was an important predictor variable for most sceptics, who were sceptical of one issue but not both, in February 2021, when most countries had experienced their first wave of the pandemic. However, the association was significantly weaker among the segment of hardcore sceptics who were both climate sceptics and antivaxxers. We demonstrate that these individuals tended to possess many of the typical sceptic characteristics such as high distrust in social institutions and rightward political orientation, which are (collectively) suggestive of an underlying sceptic mindset rather than a specific distrust of scientists. Our results suggest that different types of sceptics necessitate different strategies to dispel scepticism.
Asunto(s)
COVID-19 , Cambio Climático , Opinión Pública , Humanos , COVID-19/epidemiología , COVID-19/psicología , Encuestas y Cuestionarios , Confianza/psicología , Actitud , SARS-CoV-2/aislamiento & purificación , China/epidemiología , Australia , Femenino , Masculino , Pandemias , Brasil , India/epidemiología , Japón , Sudáfrica/epidemiologíaRESUMEN
Understanding the immune response generated by SARS-CoV-2 is critical for assessing efficient therapeutic protocols and gaining insights into the durability of protective immunity. The current work was aimed at studying the specific humoral responses against SARS-CoV-2 in Cuban COVID-19 convalescents. We developed suitable tools and methods based on ELISA methodology, for supporting this evaluation. Here, we describe the development of an ELISA for the quantification of anti-RBD IgG titers in a large number of samples and a similar test in the presence of NH4SCN as chaotropic agent for estimating the RBD specific antibody avidity. Additionally, a simple and rapid ELISA based on antibody-mediated blockage of the binding RBD-ACE2 was implemented for detecting, as a surrogate of conventional test, the levels of anti-RBD inhibitory antibodies in convalescent sera. In a cohort of 273 unvaccinated convalescents, we identified higher anti-RBD IgG titer (1 : 1,330, p < 0.0001) and higher levels of inhibitory antibodies blocking RBD-ACE2 binding (1 : 216, p < 0.05) among those who had recovered from severe illness. Our results suggest that disease severity, and not demographic features such as age, sex, and skin color, is the main determinant of the magnitude and neutralizing ability of the anti-RBD antibody response. An additional paired longitudinal assessment in 14 symptomatic convalescents revealed a decline in the antiviral antibody response and the persistence of neutralizing antibodies for at least 4 months after the onset of symptoms. Overall, SARS-CoV-2 infection elicits different levels of antibody response according to disease severity that declines over time and can be monitored using our homemade serological assays.
Asunto(s)
Anticuerpos Neutralizantes , Anticuerpos Antivirales , COVID-19 , Ensayo de Inmunoadsorción Enzimática , Inmunidad Humoral , Inmunoglobulina G , SARS-CoV-2 , Humanos , COVID-19/inmunología , SARS-CoV-2/inmunología , Anticuerpos Antivirales/sangre , Anticuerpos Antivirales/inmunología , Cuba , Masculino , Femenino , Inmunoglobulina G/sangre , Inmunoglobulina G/inmunología , Persona de Mediana Edad , Adulto , Anticuerpos Neutralizantes/inmunología , Anticuerpos Neutralizantes/sangre , Glicoproteína de la Espiga del Coronavirus/inmunología , Anciano , Enzima Convertidora de Angiotensina 2/metabolismo , Afinidad de Anticuerpos/inmunologíaRESUMEN
Influenza circulation was significantly affected in 2020-21 by the COVID-19 pandemic. During this time, few influenza cases were recorded. However, in the summer of 2021-22, an increase in atypical influenza cases was observed, leading to the resurgence of influenza in the southernmost state of Brazil, Rio Grande do Sul (RS). The present study aimed to identify the circulation of FLUAV, FLUBV and SARS-CoV-2 and characterize the influenza genomes in respiratory samples using high-throughput sequencing technology (HTS). Respiratory samples (n = 694) from patients in RS were selected between July 2021 and August 2022. The samples were typed using reverse transcriptase real-time PCR (RT-qPCR) and showed 32% (223/694) of the samples to be positive for SARS-CoV-2, 7% for FLUAV (H3) (49/694). FLUBV was not detected. RT-qPCR data also resulted in FLUAV and SARS-CoV-2 co-infections in 1.7% (4/223) of samples tested. Whole genome sequencing of FLUAV produced 15 complete genomes of the H3N2 subtype, phylogenetically classified in the 3C.2a1b.2a.2a.3 subclade and revealing the dominance of viruses in the southern region of Brazil. Mutation analysis identified 72 amino acid substitutions in all genes, highlighting ongoing genetic evolution with potential implications for vaccine effectiveness, viral fitness, and pathogenicity. This study underscores limitations in current surveillance systems, advocating for comprehensive data inclusion to enhance understanding of influenza epidemiology in southern Brazil. These findings contribute valuable insights to inform more effective public health responses and underscore the critical need for continuous genomic surveillance.
Asunto(s)
COVID-19 , Genoma Viral , Gripe Humana , Filogenia , SARS-CoV-2 , Humanos , Brasil/epidemiología , COVID-19/epidemiología , COVID-19/virología , SARS-CoV-2/genética , SARS-CoV-2/clasificación , SARS-CoV-2/aislamiento & purificación , Gripe Humana/epidemiología , Gripe Humana/virología , Persona de Mediana Edad , Adulto , Femenino , Genoma Viral/genética , Masculino , Adulto Joven , Anciano , Adolescente , Brotes de Enfermedades , Secuenciación Completa del Genoma , Niño , Preescolar , Lactante , Coinfección/epidemiología , Coinfección/virología , Secuenciación de Nucleótidos de Alto Rendimiento , Anciano de 80 o más Años , GenómicaRESUMEN
Thoracic ultrasound (TUS) is a tool that has become increasingly essential in the daily practice of thoracic medicine. Driven by the need to assess patients during the COVID-19 pandemic, there has been an increase in the use of point-of-care TUS, which has demonstrated several benefits, either as a complement to clinical decision-making for diagnosis or as a real-time guide for procedures, whether as a predictor or measure of treatment response. Here, we present a review of TUS, based on the most recent scientific evidence, from equipment and techniques to the fundamentals of pulmonary ultrasound, describing normal and pathological findings, as well as focusing on the management of lung disease and guidance for invasive thoracic procedures at the bedside. Finally, we highlight areas of perspective and potential lines of research to maintain interest in this valuable tool, in order to improve the diagnostic process and expand the treatment arsenal.
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COVID-19 , Enfermedades Pulmonares , Ultrasonografía , Humanos , COVID-19/diagnóstico por imagen , Ultrasonografía/métodos , Enfermedades Pulmonares/diagnóstico por imagen , Sistemas de Atención de Punto , Pandemias , Pulmón/diagnóstico por imagen , SARS-CoV-2RESUMEN
OBJECTIVE: The aim of this study was to demonstrate the effect of coronavirus disease 2019 on the cardiovascular autonomic system using heart rate variability in young individuals. METHODS: The study was designed retrospectively by scanning the 24-h Holter electrocardiography records of patients who applied to the Ankara Abdurrahman Yurtaslan Oncology Education and Research Hospital Cardiology outpatient clinic. The study group consisted of 492 patients under the age of 40 years, who did not have additional comorbidities or medication use and had prolonged symptoms after coronavirus disease 2019 during the pandemic. The control group, including 401 patients, was determined during the pre-pandemic period (before December 2019). Heart rate variability parameters were evaluated by scanning the 24-h Holter electrocardiography records of the patients and compared with the non-coronavirus disease 2019 group. RESULTS: The median age of participants was 30 years. Standard deviation of normal RR intervals (SDNN) ≤100 ms was more prevalent in the study group (27 (6.7%) vs 73 (14.8%), p<0.001). In univariate logistic regression analysis, the presence of coronavirus disease 2019 [(OR 2.41, 95%CI 1.52-3.83), p<0.001] and age [(OR 1.04, 95%CI 1.01-1.07), p=0.016] had a significant effect on the probability of SDNN≤100. In multivariate logistic regression analysis, the presence of coronavirus disease 2019 [(OR 2.42, 95%CI 1.52-3.85), p<0.001] and age [(OR 2.42, 95%CI 1.52-3.85), p=0.016] had a significant effect on the probability of SDNN≤100. Frequency domain measures such as, high-frequency values were significantly higher in the study group (p=0.029). The study group's low-frequency/high frequency ratio was significantly lower (p=0.019). The low-frequency/high-frequency ratio's cut-off value was ≤2.77. for determining the differentiation between coronavirus disease 2019 positive and negative cases in the receiver operating characteristic analysis. The sensitivity rate was 80.7%. The area under the curve value is 0.546 (p=0.019). CONCLUSION: This study showed that coronavirus disease 2019 causes reduced heart rate variability and increased parasympathetic activity in young patients. This may explain the prolonged symptoms after coronavirus disease 2019 infection.
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Sistema Nervioso Autónomo , COVID-19 , Electrocardiografía Ambulatoria , Frecuencia Cardíaca , Humanos , COVID-19/fisiopatología , Frecuencia Cardíaca/fisiología , Femenino , Masculino , Adulto , Estudios Retrospectivos , Sistema Nervioso Autónomo/fisiopatología , SARS-CoV-2 , Adulto Joven , PandemiasRESUMEN
OBJECTIVE: The objective of this study was to evaluate the fear, anxiety, and knowledge level in women who underwent gynecological surgical procedures during the COVID-19 pandemic. METHODS: This cross-sectional study was conducted on 188 women who underwent a gynecologic surgical operation in Mugla, Turkey. Data were collected by using demographics and obstetric detail form, questionnaire on knowledge, attitudes, and practice toward COVID-19, and State-Trait Anxiety Inventory-I (STAI-I). RESULTS: Most of the women perceived their surgical process as very urgent. Women felt fear mostly for being infected with the virus, and they were afraid of transmitting COVID-19 to another one. The COVID-19 knowledge scores of women who had undergone cancer surgery were statistically significantly higher than others (p=0.017). The STAI-I scores of women increased as their COVID-19 knowledge scores increased (p<0.05). CONCLUSION: This study demonstrated that women were afraid of COVID-19 infection during gynecological operation and due to hospitalization, sociodemographic characteristics affected the knowledge levels about COVID-19 infection, and the anxiety levels of the women. Planning appropriate interventions to decrease the fear and anxiety of women who undergo gynecological surgery during the pandemic is important to ensure that women adhere to their treatment and follow-up in the postoperative period.
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Ansiedad , COVID-19 , Miedo , Procedimientos Quirúrgicos Ginecológicos , Conocimientos, Actitudes y Práctica en Salud , Pandemias , Humanos , Femenino , COVID-19/psicología , Estudios Transversales , Ansiedad/psicología , Procedimientos Quirúrgicos Ginecológicos/psicología , Adulto , Miedo/psicología , Turquía , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven , SARS-CoV-2 , Anciano , Factores SocioeconómicosRESUMEN
BACKGROUND: After the establishment of the public health emergency of international concern in 2020, health systems worldwide and in Brazil observed the need to apply more extraordinary logistical efforts and possibly resources to combat the imminent pandemic. METHODS: Using the historical series of public expenditures of the National Health Fund (FNS), 2015 to 2021, the number of confirmed cases of COVID-19, and a seasonal ARIMAX model, we sought to assess how the increase in the new virus infections affected the systematic financing of the SUS in Brazil. RESULTS: There were signs of seasonality and an increasing trend in the expenditure variable, which in practical terms, only indicated that the resource contributions followed an increasing trajectory already underway before the advent of the pandemic. The 1% increase in COVID-19 cases, with a one-month lag, contributes to the 0.062% increase in the variation in FNS expenditures but a decrease of 0.058% with a two-month lag. CONCLUSION: The tests showed no evidence to confirm a positive shift on FNS spending growth trajectory due to the increase of COVID-19 cases, only observing a significant increase one month after the occurrence of COVID cases, probably due to their worsening after this period, which was followed by a similar and comparable decrease in percentage of growth in the following month.
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COVID-19 , Gastos en Salud , COVID-19/epidemiología , COVID-19/economía , Humanos , Brasil/epidemiología , Gastos en Salud/estadística & datos numéricos , Pandemias/economía , SARS-CoV-2 , Programas Nacionales de Salud/economía , Financiación de la Atención de la Salud , Financiación GubernamentalRESUMEN
BACKGROUND: Although important information concerning COVID-19 vaccination is available, the effects of the CoronaVac and ChadOx-1 vaccines on immunity and the redox balance in the upper airway mucosa of the aged population are not fully understood. Therefore, the aim of this study was to investigate the impacts of two doses of the CoronaVac or ChadOx-1 vaccine on immune/inflammatory responses and oxidative stress in the airway mucosa of older adults. METHODS: Seventy-six older adults of both sexes, with a mean age of 75.1 ± 6.4 years, were separated according to vaccination status into the CoronaVac (n = 52) and ChadOx-1 (n = 24) groups. Saliva samples were collected before (pre) and 30 days after (post) the administration of the second dose of the CoronaVac or ChadOx-1 vaccine to assess the levels of antibodies (sIgA and IgG), antimicrobial peptides, cytokines, and oxidant/antioxidant agents. RESULTS: The immunogenicity in the ChadOx-1 group was 37.5% for sIgA and 25% for IgG, while that in the CoronaVac group was 18.9% for sIgA and 13.2% for IgG. Intergroup analysis revealed that (1) lower levels of IFN-α, IFN-γ, and IL-10 and a greater IFN-γ/IL-10 ratio, in addition to a greater IL-6/IL-10 ratio, were found in both the pre- and postvaccination periods, and (2) lower levels of total sIgA, IL-12p70, IL-17A, TNF-α, and the IL-12p70/IL-10 ratio, in addition to higher levels of specific sIgA for SARS-CoV-2 antigens and lysozyme, were observed only in the postvaccination period in the ChadOx-1 group than in the CoronaVac group. Intragroup analysis revealed (1) a significant increase in the salivary levels of total peroxides in the postvaccination period compared to those in the prevaccination period in both volunteer groups; (2) a decrease in the levels of lysozyme and the ratio between total antioxidant capacity (TAC) and total peroxides in the postvaccination period in the CoronaVac group compared with those in the prevaccination period; and (3) decreases in the TNF-α, IL-6, and IL-12p70 levels, and the IL-12p70/IL-10 ratio in the ChadoX-1 group, as well as a higher lactoferrin concentration in the postvaccination period than in the prevaccination period. Several positive and negative correlations between the parameters assessed here were found. CONCLUSIONS: In general, the ChadOx-1 group exhibited improvements in both immune/inflammatory responses and redox balance and greater immunogenicity than did the CoronaVac group.
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Vacunas contra la COVID-19 , COVID-19 , Estrés Oxidativo , Saliva , Humanos , Femenino , Masculino , Anciano , Estrés Oxidativo/fisiología , Estrés Oxidativo/efectos de los fármacos , Saliva/metabolismo , Saliva/inmunología , Vacunas contra la COVID-19/inmunología , COVID-19/prevención & control , COVID-19/inmunología , Anciano de 80 o más Años , Citocinas/metabolismo , SARS-CoV-2/inmunología , Inmunoglobulina G , Inflamación/metabolismo , Vacunas de Productos InactivadosRESUMEN
INTRODUCTION: The discovery of the presence of the SARS-CoV-2 receptor and carrier protein in the testicles, along with the mandatory preventive social isolation during 2020 and subsequent immunization, prompted us to evaluate the effect of the COVID-19 pandemic on seminal variables in males seeking consultation at the laboratory. MATERIALS AND METHODS: An analytical and observational experimental design was employed. Seminal variables from semen analyses and kinetic values were analyzed using a computer-assisted sperm analysis system in 409 semen samples collected from patients attending the laboratory between April and December 2019, and April and December 2021. COVID-positive patients were stratified based on the time elapsed since the illness into three groups: less than 3 months (acute phase), 4-12 months, and more than 1 year. RESULTS: A significant difference (p=0.013) was found in the total sperm count per ejaculate in the COVID-positive group compared to the prepandemic and COVID-negative groups (Median (Q1-Q3): 67.49 (26.42-139.44) vs. 102.48 (43.86-197.05) and 96.72 (38.22-189.27)). When stratifying the COVID-positive group based on the time since the illness, the significant decrease (p=0.038) occurred during the acute phase, with recovery over time to values similar to the prepandemic and COVID-negative groups. Social isolation and vaccination did not have significant effects on seminal variables. DISCUSSION: The study revealed reversible changes in testicular function reflected by a decrease in sperm count in the total ejaculate of patients who had experienced COVID-19. These changes appear to be related to fever and inflammation rather than the virus infection itself.
Introducción: El hallazgo en testículo del receptor y la proteína transportadora del virus SARS-CoV-2, el aislamiento social preventivo obligatorio durante 2020 y la inmunización, nos condujeron a evaluar el efecto de la pandemia COVID-19 sobre las variables seminales de varones que consultaron al laboratorio. Materiales y métodos: Diseño experimental analítico, observacional y retrospectivo. Se analizaron las variables seminales del espermograma y los valores cinéticos mediante un sistema computarizado, en 409 muestras de semen de pacientes que concurrieron al laboratorio durante abril-diciembre 2019 y abril-diciembre 2021. Los pacientes COVID positivos fueron estratificados según el tiempo transcurrido desde la enfermedad en tres grupos: menos de 3 meses (fase aguda), 4-12 meses y más de 1 año. Resultados: Se halló diferencia significativa (p=0.013) en el recuento total de espermatozoides/eyaculado en el grupo COVID positivo con respecto al grupo prepandemia y COVID negativo (Mediana (Q1-Q3): 67.49 (26.42-139.44) vs. 102.48 (43.86-197.05) y 96.72 (38.22-189.27). Al estratificar el grupo COVID positivo según el tiempo transcurrido desde la enfermedad, la disminución significativa (p= 0.038) fue durante la fase aguda, recuperándose en el tiempo hasta llegar a valores similares a los grupos prepandemia y COVID negativo. El aislamiento social y la vacunación no tuvieron efectos significativos en las variables seminales. Discusión: El estudio evidenció cambios reversibles en la función testicular reflejado por la disminución de los espermatozoides en el total eyaculado de pacientes que habían tenido COVID-19. Estos cambios parecen estar relacionados con la fiebre y la inflamación y no a causa de la infección por el virus.
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COVID-19 , Análisis de Semen , Humanos , COVID-19/prevención & control , Masculino , Adulto , Persona de Mediana Edad , SARS-CoV-2 , Recuento de Espermatozoides , Pandemias , Semen/virología , Factores de Tiempo , Motilidad Espermática , Adulto JovenRESUMEN
The effects of the COVID-19 pandemic on comprehensive maternal deaths in Brazil have not been fully explored. Using publicly available data from the Brazilian Mortality Information (SIM) and Information System on Live Births (SINASC) databases, we used two complementary forecasting models to predict estimates of maternal mortality ratios using maternal deaths (MMR) and comprehensive maternal deaths (MMRc) in the years 2020 and 2021 based on data from 2008 to 2019. We calculated national and regional standardized mortality ratio estimates for maternal deaths (SMR) and comprehensive maternal deaths (SMRc) for 2020 and 2021. The observed MMRc in 2021 was more than double the predicted MMRc based on the Holt-Winters and autoregressive integrated moving average models (127.12 versus 60.89 and 59.12 per 100,000 live births, respectively). We found persisting sub-national variation in comprehensive maternal mortality: SMRc ranged from 1.74 (95% confidence interval [CI] 1.64, 1.86) in the Northeast to 2.70 (95% CI 2.45, 2.96) in the South in 2021. The observed national estimates for comprehensive maternal deaths in 2021 were the highest in Brazil in the past three decades. Increased resources for prenatal care, maternal health, and postpartum care may be needed to reverse the national trend in comprehensive maternal deaths.
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COVID-19 , Mortalidad Materna , Pandemias , Humanos , COVID-19/mortalidad , COVID-19/epidemiología , Brasil/epidemiología , Femenino , Mortalidad Materna/tendencias , Embarazo , SARS-CoV-2/aislamiento & purificación , Muerte Materna/estadística & datos numéricos , Adulto , Bases de Datos FactualesRESUMEN
INTRODUCTION: Orofacial pain and tension headache are symptoms that affect a large portion of the population, compromising productivity, social ability, and functional development. The treatment for reducing painful sensation should be chosen carefully, as pharmacological treatment may bring side effects and overload the organism of patients in pain. Low-level laser therapy has been used with local and systemic [vascular] applications for pain control. However, there is still uncertainty in the literature about the ideal dosimetric parameters for photobiomodulation treatment according to patient characteristics. METHODS: The objective of this project is to validate a dosimetry model based on the relationship between the effects of photobiomodulation with anthropometric and hemodynamic variables, both in local application and systemic application in patients with symptoms of orofacial pain and tension headache. For this purpose, 180 participants with orofacial pain post-covid eligible participants will be randomly assigned to Group 1-Local Photobiomodulation, Group 2-Vascular Photobiomodulation, Group 3-Placebo Local Photobiomodulation, or Group 4-Placebo Vascular Photobiomodulation [Therapy EC-DMC device, São Carlos, Brazil,- 660 nm, 100mW] using stratified block randomization. Before the application, sociodemographic information such as age, skin phototype [classified by the Fitzpatrick scale], weight, height, body mass index [BMI], oxygen saturation [SaO2], blood pressure [BP], heart rate [HR], and thickness of skin, fat, and facial muscles will be collected. During the application, we will collect local temperature, SaO2, BP, and HR. Before and after laser application, blood levels of lactate and hemoglobin, BP, and HR will be measured in the first and last session. In addition to demographic, anthropometric, and hemodynamic variables, the penetrated energy will be quantified using a power meter, and information from orofacial pain and headache symptom questionnaires will be analyzed. The Monte Carlo simulation technique will be used to systematically study the relationship between the light penetration profile into the target tissues and the most relevant variables, namely BMI, tissue layer thicknesses, and skin phototype. Light transmittance, measured in vivo and simulated, will be compared to validate a personalized dosimetry model. DISCUSSION: The results of this study contribute to validating a Monte Carlo Simulation model to calculate the appropriate dosimetry for photobiomodulation therapies in the control of patients with Post-Covid-19 orofacial pain. TRIAL REGISTRATION: Trial registration number: NCT06065969.
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COVID-19 , Dolor Facial , Hemodinámica , Terapia por Luz de Baja Intensidad , Humanos , Terapia por Luz de Baja Intensidad/métodos , COVID-19/complicaciones , COVID-19/radioterapia , Dolor Facial/radioterapia , Dolor Facial/fisiopatología , Masculino , Femenino , Adulto , Antropometría , Persona de Mediana Edad , Radiometría , SARS-CoV-2 , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
COVID-19 is characterized by pronounced hypercytokinemia. The cytokine switch, marked by an imbalance between pro-inflammatory and anti-inflammatory cytokines, emerged as a focal point of investigation throughout the COVID-19 pandemic. However, the kinetics and temporal dynamics of cytokine release remain contradictory, making the development of new therapeutics difficult, especially in severe cases. This study collected serum samples from SARS-CoV-2 infected patients at 72 h intervals and monitored them for various cytokines at each timepoint until hospital discharge or death. Cytokine levels were analyzed based on time since symptom onset and patient outcomes. All cytokines studied prospectively were strong predictors of mortality, particularly IL-4 (AUC = 0.98) and IL-1ß (AUC = 0.96). First-timepoint evaluations showed elevated cytokine levels in the mortality group (p < 0.001). Interestingly, IFN-γ levels decreased over time in the death group but increased in the survival group. Patients who died exhibited sustained levels of IL-1ß and IL-4 and increased IL-6 levels over time. These findings suggest cytokine elevation is crucial in predicting COVID-19 mortality. The dynamic interplay between IFN-γ and IL-4 highlights the balance between Th1/Th2 immune responses and underscores IFN-γ as a powerful indicator of immune dysregulation throughout the infection.
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COVID-19 , Citocinas , Interleucina-4 , SARS-CoV-2 , Humanos , COVID-19/inmunología , COVID-19/sangre , COVID-19/mortalidad , Masculino , Femenino , Persona de Mediana Edad , Citocinas/sangre , SARS-CoV-2/inmunología , Anciano , Interleucina-4/sangre , Estudios Prospectivos , Interferón gamma/sangre , Interleucina-1beta/sangre , Adulto , Interleucina-6/sangreRESUMEN
The COVID-19 pandemic has overwhelmed healthcare systems and triggered global economic downturns. While vaccines have reduced the lethality rate of SARS-CoV-2 to 0.9% as of October 2024, the continuous evolution of variants remains a significant public health challenge. Next-generation medical therapies offer hope in addressing this threat, especially for immunocompromised individuals who experience prolonged infections and severe illnesses, contributing to viral evolution. These cases increase the risk of new variants emerging. This study explores miniACE2 decoys as a novel strategy to counteract SARS-CoV-2 variants. Using in silico design and molecular dynamics, blocking proteins (BPs) were developed with stronger binding affinity for the receptor-binding domain of multiple variants than naturally soluble human ACE2. The BPs were expressed in E. coli and tested in vitro, showing promising neutralizing effects. Notably, miniACE2 BP9 exhibited an average IC50 of 4.9 µg/mL across several variants, including the Wuhan strain, Mu, Omicron BA.1, and BA.2 This low IC50 demonstrates the potent neutralizing ability of BP9, indicating its efficacy at low concentrations.Based on these findings, BP9 has emerged as a promising therapeutic candidate for combating SARS-CoV-2 and its evolving variants, thereby positioning it as a potential emergency biopharmaceutical.